PuSH - Publication Server of Helmholtz Zentrum München: Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities.

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Meng, X.* ; Liu, C.* ; Chen, R.* ; Sera, F.* ; Vicedo-Cabrera, A.M.* ; Milojevic, A.* ; Guo, Y.* ; Tong, S.* ; Coelho, M.S.Z.S.* ; Saldiva, P.H.N.* ; Lavigne, E.* ; Correa, P.M.* ; Ortega, N.V.* ; Osorio, S.* ; Garcia, S.O.* ; Kyselý, J.* ; Urban, A.* ; Orru, H.* ; Maasikmets, M.* ; Jaakkola, J.J.K.* ; Ryti, N.* ; Huber, V.* ; Schneider, A.E. ; Katsouyanni, K.* ; Analitis, A.* ; Hashizume, M.* ; Honda, Y.* ; Ng, C.F.S.* ; Nunes, B.* ; Teixeira, J.P.* ; Holobaca, I.H.* ; Fratianni, S.* ; Kim, H.* ; Tobias, A.* ; Iñiguez, C.* ; Forsberg, B.* ; Åström, C.* ; Ragettli, M.S.* ; Guo, Y.L.* ; Pan, S.C.* ; Li, S.* ; Bell, M.L.* ; Zanobetti, A.* ; Schwartz, J.* ; Wu, T.* ; Gasparrini, A.* ; Kan, H.*

Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities.

BMJ 372:n534 (2021)

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OBJECTIVE: To evaluate the short term associations between nitrogen dioxide (NO₂) and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide, using a uniform analytical protocol. DESIGN: Two stage, time series approach, with overdispersed generalised linear models and multilevel meta-analysis. SETTING: 398 cities in 22 low to high income countries/regions. MAIN OUTCOME MEASURES: Daily deaths from total (62.8 million), cardiovascular (19.7 million), and respiratory (5.5 million) causes between 1973 and 2018. RESULTS: On average, a 10 μg/m³ increase in NO₂ concentration on lag 1 day (previous day) was associated with 0.46% (95% confidence interval 0.36% to 0.57%), 0.37% (0.22% to 0.51%), and 0.47% (0.21% to 0.72%) increases in total, cardiovascular, and respiratory mortality, respectively. These associations remained robust after adjusting for co-pollutants (particulate matter with aerodynamic diameter ≤10 μm or ≤2.5 μm (PM₁₀ and PM_2.5, respectively), ozone, sulfur dioxide, and carbon monoxide). The pooled concentration-response curves for all three causes were almost linear without discernible thresholds. The proportion of deaths attributable to NO₂ concentration above the counterfactual zero level was 1.23% (95% confidence interval 0.96% to 1.51%) across the 398 cities. CONCLUSIONS: This multilocation study provides key evidence on the independent and linear associations between short term exposure to NO₂ and increased risk of total, cardiovascular, and respiratory mortality, suggesting that health benefits would be achieved by tightening the guidelines and regulatory limits of NO₂.

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Publication type Article: Journal article

Document type Scientific Article

Language english

Publication Year 2021

HGF-reported in Year 2021

ISSN (print) / ISBN 0959-535X

e-ISSN 1756-1833

Journal BMJ

Quellenangaben Volume: 372, Article Number: n534

Publisher British Medical Association

Publishing Place London

Reviewing status Peer reviewed

Institute(s) Institute of Epidemiology (EPI)

POF-Topic(s) 30202 - Environmental Health

Research field(s) Genetics and Epidemiology

PSP Element(s) G-504000-001

Grants Academy of Finland
China Medical Board Collaborating Program
Medical Research Council, UK
Natural Environment Research Council, UK
European Union
Spanish Ministry of Science and Innovation
German Federal Ministry of Education and Research
Environment Research and Technology Development Fund of the Environmental Restoration and Conservation Agency, Japan
Czech Science Foundation
Shanghai Municipal Science and Technology Commission
Career Development Fellowship of the Australian National Health and Medical Research Council
Early Career Fellowship of the Australian National Health and Medical Research Council
National Natural Science Foundation of China

DOI 10.1136/bmj.n534

WOS ID WOS:000637833700009

Scopus ID 85103370304

PubMed ID 33762259

Erfassungsdatum 2021-04-20

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